Mental Health issues in Mental Health issues in Pakistan: Pakistan:

Prof. Dr. Haroon Rashid ChaudhryProf. Dr. Haroon Rashid Chaudhry

Head Department of Psychiatry, Fatima Jinnah Medical College Sir Ganga Ram Hospital, Lahore Honorary Executive Director, Fountain House, Lahore. President, Pakistan Psychiatric Society General Secretary, South Asian Forum (Pakistan-Chapter) Secretary, WPA Section on Rural Mental Health Member, WPA Operational Committee on Scientific Meetings Board Member, World Association of Psychosocial Rehabilitation VP, World Federation for Mental Health, Eastern Mediterranean Region

General Secretary, SAARC Psychiatric Federation

WHAT IS HEALTH?

World Health Organization's Definition

“A state of complete physical, mental, social and spiritual well being and

not merely the absence of disease or infirmity”

GLOBAL MENTAL HEALTH ISSUES

More than two fifths of the total disabilities are due to mental illnesses

(WORLD HEALTH REPORT, 2001)

DISEASES IN 2020

Myocardial infarction Depression Road Traffic Accident Tuberculosis Alcohol

(Leading causes of Disability in DALYS Estimated in 2020)

A mental health or mental disorder is A mental health or mental disorder is a psychological or behavioral pattern a psychological or behavioral pattern associated with distress or disability associated with distress or disability that occurs in an individual and is not that occurs in an individual and is not a part of normal development and a part of normal development and culture culture

MENTAL HEALTH SCENARIO IN PAKISTAN

Total Population169,954,000

(July 2010 est.)

Psychiatrists 400

Clinical Psychologists 200

Psychiatric Social Workers 30

Pakistan has an estimated population Pakistan has an estimated population of 14 million Mentally ill patients, the of 14 million Mentally ill patients, the majority of which are womenmajority of which are women

6000-8000 people committ suicide 6000-8000 people committ suicide every year in Pakistan and the trend every year in Pakistan and the trend in increasing (Doesn’t include Suicide in increasing (Doesn’t include Suicide Bombers)Bombers)

MENTAL HEALTH FACILITIES AT THE MENTAL HEALTH FACILITIES AT THE TIME OF INDEPENDENCE (1947)TIME OF INDEPENDENCE (1947)

Mental Hospital in Lahore Mental Hospital in Lahore

(Punjab Institute of Mental (Punjab Institute of Mental

Health).Health).

Mental Hospital in Hyderabad Mental Hospital in Hyderabad

(Sir Cows Jee Mental Hospital)(Sir Cows Jee Mental Hospital)

Mental Hospital Peshawar Mental Hospital Peshawar 19501950

Mental Hospital Dodial Mental Hospital Dodial 19631963

Pakistan has only one Pakistan has only one psychiatrist for every 10,000 psychiatrist for every 10,000 people, one child psychiatrist for people, one child psychiatrist for four million children who are four million children who are estimated to be suffering from estimated to be suffering from mental-health issues, only four mental-health issues, only four major psychiatric hospitals in a major psychiatric hospitals in a country of 165 million and only country of 165 million and only 20 such units attached to 20 such units attached to teaching hospitalsteaching hospitals

NO MENTAL HEALTH NO MENTAL HEALTH REHAB FACILITY WAS REHAB FACILITY WAS AVAILABLE TILL 1970AVAILABLE TILL 1970

FOUNTAIN HOUSEFOUNTAIN HOUSE(1971-2010)(1971-2010)

Project of Lahore Mental Project of Lahore Mental Health Association Health Association

CONCEPTS OF MENTAL CONCEPTS OF MENTAL ILLNESSILLNESS

Once a psychiatric patient forever a Once a psychiatric patient forever a psychiatric patientpsychiatric patient

Possession (any bizarre behaviour)Possession (any bizarre behaviour)– Conversion Reaction Conversion Reaction – SchizophreniaSchizophrenia– Puerperal PsychosisPuerperal Psychosis

No improvementNo improvement

CURRENT SCENARIOCURRENT SCENARIO

– Primary psychiatric carePrimary psychiatric careGPsGPsClergymen & Faith HealersClergymen & Faith HealersHakeemsHakeemsHomeopathsHomeopathsShrine/Mosque / Church / TempleShrine/Mosque / Church / Temple

– Secondary psychiatric careSecondary psychiatric care– Tertiary Psychiatric Facilities Tertiary Psychiatric Facilities

(Teaching Hospitals)(Teaching Hospitals)

DILEMMA OF PSYCHIATRIC CARE IN PAKISTAN

Stigma

Shortage of mental health professionals

Insufficient psychiatric beds

Brain drain

Inadequate psychiatric services in periphery

No structured training programmes for GPs

Mental Health Act (2001)Mental Health Act (2001)

Activities of mental health NGOsActivities of mental health NGOs

Recognition of mental health in general Recognition of mental health in general health care ?health care ?

International collaborationsInternational collaborations- Training- Training- Research - Research

CHANGE IN SENAIRIO CHANGE IN SENAIRIO

SUGGESTIONSSUGGESTIONS

Psychiatric faculty development in teaching hospitalsPsychiatric faculty development in teaching hospitals

Post of consultant psychiatrist in tehsils and districtsPost of consultant psychiatrist in tehsils and districts

Implementation of mental health actImplementation of mental health act

Public awareness programmes addressing mental Public awareness programmes addressing mental health issueshealth issues

Structured training of GPs (in collaboration with)Structured training of GPs (in collaboration with)– Academy of Family Physicians Academy of Family Physicians – Pakistan Psychiatric Society Pakistan Psychiatric Society – WPA Section on EducationWPA Section on Education– Pakistan Medical and Dental CouncilPakistan Medical and Dental Council

THANK YOU